The pain scale at a glance
This is a plain-language guide to help you talk about your pain. It is not a medical test.
| Score | What the pain does to your day |
|---|---|
| 0 | No pain. Your day is not affected. |
| 1 | Barely there. You do everything you planned. You forget about it most of the time. |
| 2 | Mild. You go about your day as usual. |
| 3 | Noticeable. You can still work, study and see people. You may take a painkiller or use a heat pad. |
| 4 | Distracting. You can work or study, but you get less done. You may skip exercise or plans after work. |
| 5 | Hard to ignore. You can still work, but it takes effort. You may leave early or cancel plans. |
| 6 | Makes you stop. You have to stop what you are doing and rest, often with a heat pad. Chores and plans wait. |
| 7 | Stops your day. You lie down for most of the day. You cannot work, study or care for others as usual, and it can be hard to sleep. |
| 8 | Intense. You are curled up in bed or on the sofa. You cannot work, moving around is hard, and you may feel sick. |
| 9 | Very severe. You cannot do anything except try to cope with the pain. You may vomit or need help to get to the toilet. |
| 10 | Worst possible. You cannot get up or move. You may vomit, feel faint or pass out. |
How to rate your period pain
- Rate the pain at its worst, and also your usual level. “Usually a 4, but a 9 on the first day” tells a doctor far more than “about a 6”.
- Pick the number by what you can and cannot do. Do not play the pain down.
- Rate it on the day, or the same evening, while you still remember it well.
- Use the same scale every time, so your scores can be compared across cycles.
Why the number alone is not enough
One person’s 6 can be another person’s 8. The link between a score and how much pain gets in the way of daily life differs from one group of people to another. So write down these four things with every score:
- How long it lasted. Period pain usually lasts up to 3 days. Pain that starts days before your period, or does not go away after it ends, can be a sign of another condition, such as endometriosis.
- Where it was. Low in the belly, one side, the lower back, the thighs. Period cramps can spread to your hips, lower back and inner thighs.
- What it stopped you doing. Missed work, school, sleep or plans. This is often what a doctor needs most.
- What helped. Each painkiller, the dose, and whether it worked. Add heat pads or other things you tried.
For the words to describe the kind of pain, see how to describe period pain.
When a score means see a doctor
Usually, period pain is mild. For some people it is so severe that it keeps them from doing their normal activities for several days a month. See a doctor if:
- Your pain often reaches 6 or more on this scale, which means it stops you doing your usual daily activities.
- Your periods become more painful, heavier or irregular.
- Cramps last for more than three days.
- You have pain during sex, or when you pee or poo.
- Painkillers do not help. If medicine does not relieve the pain, treatment should focus on finding the cause.
When to get urgent help
Get medical advice the same day if your period pain is severe or worse than usual, and painkillers have not helped.
Call 911 in the US or 999 in the UK, or go to the emergency department, if you have pelvic pain and any of these:
- The pain is severe, getting worse, or hurts when you move or touch the area.
- You feel faint, dizzy or lightheaded, or you pass out.
- You have pain in the tip of your shoulder.
- You have difficulty breathing.
- You have heavy bleeding from your vagina.
- You suddenly feel confused.
If you have pelvic pain and you are, or could be, pregnant, get medical advice the same day.
Track your pain over time
One score shows one day. A record over two or three cycles shows the pattern. You can keep that record in Endolog, a pain and symptom diary.
Sources
- Period pain, NHS
- Pelvic pain, NHS
- Dysmenorrhea: painful periods, American College of Obstetricians and Gynecologists (ACOG)
- Dysmenorrhea (painful periods), Cleveland Clinic
- World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonization Project: II. Clinical and covariate phenotype data collection in endometriosis research (Vitonis AF et al. Fertility and Sterility, 2014), Fertility and Sterility
- Cut-off points for mild, moderate, and severe pain on the numeric rating scale for pain in patients with chronic musculoskeletal pain (Boonstra AM et al. Frontiers in Psychology, 2016), Frontiers in Psychology
This page is for general information. It does not replace care from a doctor. Read how we write and check our content in our editorial policy.